What is Family Connections?

introducing

Family ConnectionsDiane DePanfilis, Ph.D., MSWFamily Connections Developer

ImplementationStaffing, supervision, training, fidelityassessment, implementation support5

OUTCOMESIntermediate and Final Outcomes4

TARGET POPULATIONRisk of maltreatment and/or out-of-home placement, Families withchildren Birth to age 18

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CORE COMPONENTSIntake, Outreach, Concrete Needs, FamilyAssessment, Outcome Driven ServicePlanning, Change Focused Intervention,Evaluation of Change, Service Termination

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OVERVIEW

• History• Underlying Philosophy

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OUTLINE for Today

• How was the model developed?

Home & Community Based Social Work Practice Model

Interdisciplinary & Consumer Involvement

Implementation Science

Intervention Research

Prevention Science Conceptual Framework forDevelopment

History of Family Connections

*Federal Demonstrations

-OCAN-SAMHSA

*FederalSupported

Replications*SAMHSA support to

develop TA-FC

*Rated as Promising Practice

*Special Issue of Protecting Children

*JBA Final Report*Implementation

in CA, MD, MI, NJ, TX

*Major implementations in NYC & Florida

*Numerous papers published

*Studies on implementation*Reflection on what supports

are essential for implementation

1996-2002

*Expansion of QA capacity by

replicating sites

*Data sharing

2003-20092010-2012

2013-20142015-2016

2017-2019

Theories that Guide The Intervention

• Psychosocial Theory• Problem-Solving Theory• Life Model Theory• Crisis Theory• Systems Theory• Role Theory• Cognitive Theory

• Empowerment Approach

• Trauma Theory• Attachment Theory• Trans Theoretical Model

of Change

CulturalCompetence

EcologicalDevelopmental

Framework

Empowerment &Strengths BasedPractice

CommunityOutreach

Philosophical Principles

Practice Principles

Philosophical

Focus onPractitionerFamily

Assessment& Tailored

Intervention

Outcome Driven PlansWith SMARTGoals

HelpingAlliance

Core Components

Family Connections (FC)

• FC Core Components– Intake– Outreach & engagement– Concrete services– Comprehensive family

assessment (assessment instruments)

– Outcome driven case plans with SMART goals

– Change focused intervention• Direct facilitation of change• Advocacy/service facilitation

– Evaluation of Change(at least every 90 days)

– Case Closure

Is a multi-faceted community-based program that works with vulnerable families in their homes, in the context of their neighborhoods, to help them meet the basic needs of their children and prevent child maltreatment.

Outreach & Engagement•Within 1 business day CP conducts face to face visit

with family

2nd

CASI

Comprehensive Family Assessment (CFA)

•30-45 days from signing for services

Outcome Drive Service Plan w/SMART goals

•14 days after completion of CFA

Emergency & Concrete Services

•Ongoing Assessment throughout life of services

Change Focused Intervention

•Facilitation of Change•Advocacy/service

facilitation

Service Plan Evaluation•Evaluation of Change

form completed 90 days after service plan

Intake•Complete Intake &

Screening Form

CASI•2nd-3rd visit

Administer 3rd CASI if needed•2nd Evaluation of Change

form

Negotiate new Service Plan with family

Case Closure•Complete 7 point case

closure

Case Closure•Complete 7 point case

closure

Family Connections Flow Chart

Achieved

Insufficient change

Comprehensive Family Assessment Process CFA Product

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• Target Population

Families with children from birth to age 18 at risk of maltreatment and/or placement

Outcomes

Child & Family, Program

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Original Logic Model - Family Connections

Inputs

Diverse Funding

Eligibility Criteria and

Referral Procedures

Trained &Supervised

Staff

InterventionManual

Intermediate Outputs

Emergency Assistance

Comprehensive FamilyAssessment

SMART Case Plan

Change Focused Counseling & Advocacy

Case Plan Evaluation

FinalOutputs

Number offamilies

who complete services

Short-Term/ Intermediate Outcomes

Increase Protective Factors

• Parenting Attitudes• Parenting Competence• Social Support

Decrease Risk Factors

• Life Stress• Parenting Stress• Parental Depressive

Symptoms

Long-Term Outcomes

Increase childsafety

Increase childwell-being

Increase childpermanency/

stability

Intake,Outreach/Engagement

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Summary Results: Risk Factors

• Comparing all caregivers baseline to 6 months post intervention, significant reduction in:

ü Risk FactorsüCaregiver depressive symptoms

üParenting stressüLife stress

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Summary Results: Protective Factors

• Comparing all families baseline to 6 months post intervention, significant increase in:

üProtective FactorsüParenting attitudes

üParenting satisfactionüSocial support

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Summary Results: Child Safety

• Significantly Improved: Physical Care– Household furnishings

– Overcrowding– Household sanitation

• Significantly Improved: Psychological Care– Mental health care

– Caregiver teaching stimulation of children

• Fewer CPS reports & CPS indicated reports

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Summary Results: Child Behavior

• Comparing all families baseline to 6 months post intervention,

significant decrease in:

ü Total behavior problemsüInternalizing behavior problemsüExternalizing behavior problems

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Replication of Family Connections

• Formal replication in 8 sites in the U.S. with support from the U.S. DHHS Children’s Bureau

• Cross-site evaluation of implementation process, fidelity, cost, & outcomes

Snapshots of findings abstracted from: James Bell Associates, Inc. (2011, September).National Cross-Site Evaluation of the Replication of Family Connections: Final EvaluationReport. Submitted to the Office on Child Abuse and Neglect, Children’s Bureau, ACYF, ACF, HHS

Conducted by James Bell Associates (JBA)

Summary Outcomes: Change Over Time

• Significant improvement in Risk Factors– Decreased caregiver depressive symptoms (CESD)– Decreased parenting stress (PSI)

• Significant improved child well-being– Decreased scores on children’s externalizing and

internalizing behaviors (CBCL)

Summary Outcomes: Change Over Time

• Significant improvement in Protective Factors– Appropriate Nurturing & Parenting Attitudes

(AAPI) - higher scores on 5 sub-scales: Developmental Expectations, Empathy, Corporal Punishment, Role Reversal, and Power Independence

– Social Support (SFS) – decreased need for support in the areas of emotional support, daily living, and child rearing

– Family Functioning (FAF) – improved family functioning scores

Moderating Effect of Fidelity

• Families at sites with higher fidelity scores on program structure reported significantly greater reductions in parenting stress, caregiver depressive symptoms, and need for support.

• Families at sites with higher philosophical principle fidelity scores showed less need for social support over time and decreases in the number of critical dimensions of family functioning.

• Families at sites with higher administrative activities fidelity scores demonstrated greater reductions in child internalizing behaviors and improvements in parental attitudes but less improvement on family functioning.

Implementation Supports

Staffing, Supervision, Length of Service, Training, Fidelity Monitoring, Implementation Collaborative

STAFFING

SUPERVISION

LENGTH of SERVICE

TRAINING

FIDELITY

Implementation

Local Capacity

National Coordination

CombinedResources

ACTION for Child Protection staff and consultants provide training, technical assistance, and implementation support.

Each replication is individualized and tailored

? For further information,

Contact: Diane DePanfilis, dd482@hunter.cuny.edu; 917-453-2296